The American journal of emergency medicine
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Comparative Study
The diagnostic accuracy of an abdominal radiograph with signs and symptoms of intussusception.
The objective of this study was to compare the diagnostic accuracy of an abdominal ultrasound to that of a highly suggestive abdominal radiograph combined with signs and symptoms of intussusception. ⋯ Ultrasound is not needed before an enema for the diagnosis of intussusception for those with a highly suggestive abdominal radiograph, abdominal pain, lethargy, and vomiting.
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Hyperlactatemia may be associated with poor outcome in patients with ischemic stroke because it reflects a state of tissue perfusion. This study aims to know whether initial hyperlactatemia in the emergency department (ED) is associated with poor outcome in patients with ischemic stroke. ⋯ Among patients with ischemic stroke, initial hyperlactatemia represents an independent risk factor for poor outcome after controlling for stroke severity, risk factors, initial glucose level, and interval from onset of stroke symptoms to ED arrival.
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Evaluation of rates of spontaneous abortion (SAB) may aid in counseling pregnant patients seen in the emergency department (ED). A recent chart review reported an SAB rate of 10% among ED patients with a documented intrauterine pregnancy (IUP) and cardiac activity on ultrasound. We sought to prospectively evaluate outcomes among pregnant ED patients with documented cardiac activity on ultrasound. ⋯ In this study, which represents the first prospective evaluation of ED patients with documented IUP with fetal heart tones, the rate of SAB was consistent with that reported previously for this population. These results confirm that ED patients represent a high-risk group, and additional research is needed to better characterize risk factors for SAB.
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Clinical Trial
Prochlorperazine in children with migraine: a look at its effectiveness and rate of akathisia.
The objective of this study is to evaluate the effectiveness of prochlorperazine and the rate of akathisia in children with severe migraine. ⋯ Prochlorperazine seems very effective to decrease pain on a short-term basis in children. However, more than two thirds of the patients, overall, had a relapse of their migraine at home in the first week. Despite the use of diphenhydramine, akathisia remains a concern.
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Case Reports
A hyperparathyroid case with pulmonary edema: can hypercalcemia trigger pulmonary edema?
Most cases of pulmonary edema presenting with hypercalcemia are associated with malignant hypercalcemia and related with metastatic calcification. Most patients have predisposing factors such as hematological and solid organ malignancies and chronic renal failure. ⋯ A 72-year-old female patient was admitted to the emergency service with pulmonary edema and moderate hypercalcemia because of primary hyperparathyroidism. In this presented case, we have discussed the 72-year-old female patient admitted with acute pulmonary edema who had primary hyperparathyroidism.